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Ventricular bigeminy

MedGen UID:
75503
Concept ID:
C0262662
Finding
Synonym: Bigeminal rhythm
SNOMED CT: Ventricular bigeminy (11157007); Bigeminal rhythm (11157007)
 
HPO: HP:0034306

Definition

An electrocardiographic finding of a normal QRS followed by a premature ventricular contraction; a rhythmic pairing of normal and atypical beats originating in the ventricles in a 1-1 ratio such that an ectopic ventricular beat follows each regular heartbeat. [from HPO]

Conditions with this feature

Long QT syndrome 15
MedGen UID:
864132
Concept ID:
C4015695
Disease or Syndrome
Long QT syndrome (LQTS) is a cardiac electrophysiologic disorder, characterized by QT prolongation and T-wave abnormalities on the EKG that are associated with tachyarrhythmias, typically the ventricular tachycardia torsade de pointes (TdP). TdP is usually self-terminating, thus causing a syncopal event, the most common symptom in individuals with LQTS. Such cardiac events typically occur during exercise and emotional stress, less frequently during sleep, and usually without warning. In some instances, TdP degenerates to ventricular fibrillation and causes aborted cardiac arrest (if the individual is defibrillated) or sudden death. Approximately 50% of untreated individuals with a pathogenic variant in one of the genes associated with LQTS have symptoms, usually one to a few syncopal events. While cardiac events may occur from infancy through middle age, they are most common from the preteen years through the 20s. Some types of LQTS are associated with a phenotype extending beyond cardiac arrhythmia. In addition to the prolonged QT interval, associations include muscle weakness and facial dysmorphism in Andersen-Tawil syndrome (LQTS type 7); hand/foot, facial, and neurodevelopmental features in Timothy syndrome (LQTS type 8); and profound sensorineural hearing loss in Jervell and Lange-Nielson syndrome.

Professional guidelines

PubMed

Arora R, Jolly N, Singh B, Mohan JC, Kalra GS, Sethi KK, Khalilullah M
Indian Heart J 1991 Sep-Oct;43(5):357-60. PMID: 1820997
Dreifus LS, Michelson EL, Kaplinsky E
J Am Coll Cardiol 1983 Jan;1(1):327-38. doi: 10.1016/s0735-1097(83)80033-3. PMID: 6826942
Wing JP, Phibbs B
Heart Lung 1977 Nov-Dec;6(6):995-1004. PMID: 244329

Recent clinical studies

Etiology

Littmann L, Tenczer J
J Electrocardiol 2020 Sep-Oct;62:73-78. Epub 2020 Aug 15 doi: 10.1016/j.jelectrocard.2020.08.011. PMID: 32835983
Verba SD, Jensen BT, Lynn JS
Wilderness Environ Med 2016 Sep;27(3):364-70. Epub 2016 Jul 7 doi: 10.1016/j.wem.2016.03.005. PMID: 27396923
Sabbag A, Sidi Y, Kivity S, Beinart R, Glikson M, Segev S, Goldenberg I, Maor E
Eur J Prev Cardiol 2016 Mar;23(5):511-7. Epub 2015 Jun 11 doi: 10.1177/2047487315591442. PMID: 26069245
Akoum NW, Daccarett M, Wasmund SL, Hamdan MH
Pacing Clin Electrophysiol 2011 Mar;34(3):291-5. Epub 2010 Nov 11 doi: 10.1111/j.1540-8159.2010.02947.x. PMID: 21070255
Anastasiadis PG, Anninos P, Kotini A, Koutlaki N, Garas A, Galazios G
Clin Exp Obstet Gynecol 2001;28(4):257-60. PMID: 11838754

Diagnosis

Azevedo ACA, Barros MVL, Klaboe LG, Edvardsen T, Costa HS, Paixao GMM, Junior ORS, Nunes MCP, Rocha MOC
Int J Cardiovasc Imaging 2021 Sep;37(9):2727-2734. Epub 2021 Apr 21 doi: 10.1007/s10554-021-02246-8. PMID: 33881664
Conte G, Giudicessi JR, Ackerman MJ
Europace 2021 Jan 27;23(1):4-10. doi: 10.1093/europace/euaa211. PMID: 33038214
Teplitzky BA, McRoberts M, Ghanbari H
Heart Rhythm 2020 May;17(5 Pt B):881-888. doi: 10.1016/j.hrthm.2020.02.015. PMID: 32354454Free PMC Article
Egom EE, Wong KY, Clark AL
BMJ Case Rep 2011 May 16;2011 doi: 10.1136/bcr.12.2010.3594. PMID: 22696760Free PMC Article
Anastasiadis PG, Anninos P, Kotini A, Koutlaki N, Garas A, Galazios G
Clin Exp Obstet Gynecol 2001;28(4):257-60. PMID: 11838754

Therapy

Adetiloye AO, Abdelmottaleb W, Ahmed MF, Victoria AM, Ozbay MB, Valencia Manrique JC, Alaameri R, Badero O, Mushiyev S
Am J Case Rep 2022 Jul 6;23:e936306. doi: 10.12659/AJCR.936306. PMID: 35793273Free PMC Article
Kaushal M, Tolani P, Kumar N, Chopda A
Natl Med J India 2019 Jul-Aug;32(4):216-217. doi: 10.4103/0970-258X.291293. PMID: 32769242
Miśkowiec D, Życiński P, Qawoq DH, Pagórek P, Zając P, Chudzik M, Wcisło T, Kasprzak JD
Ann Noninvasive Electrocardiol 2019 Sep;24(5):e12666. Epub 2019 Jun 26 doi: 10.1111/anec.12666. PMID: 31241241Free PMC Article
Tripathy RK, Sharma LN, Dandapat S
J Med Syst 2016 Apr;40(4):79. Epub 2016 Jan 21 doi: 10.1007/s10916-016-0441-5. PMID: 26798076
Egom EE, Wong KY, Clark AL
BMJ Case Rep 2011 May 16;2011 doi: 10.1136/bcr.12.2010.3594. PMID: 22696760Free PMC Article

Prognosis

Azevedo ACA, Barros MVL, Klaboe LG, Edvardsen T, Costa HS, Paixao GMM, Junior ORS, Nunes MCP, Rocha MOC
Int J Cardiovasc Imaging 2021 Sep;37(9):2727-2734. Epub 2021 Apr 21 doi: 10.1007/s10554-021-02246-8. PMID: 33881664
Teplitzky BA, McRoberts M, Ghanbari H
Heart Rhythm 2020 May;17(5 Pt B):881-888. doi: 10.1016/j.hrthm.2020.02.015. PMID: 32354454Free PMC Article
Kaushal M, Tolani P, Kumar N, Chopda A
Natl Med J India 2019 Jul-Aug;32(4):216-217. doi: 10.4103/0970-258X.291293. PMID: 32769242
Verba SD, Jensen BT, Lynn JS
Wilderness Environ Med 2016 Sep;27(3):364-70. Epub 2016 Jul 7 doi: 10.1016/j.wem.2016.03.005. PMID: 27396923
Sabbag A, Sidi Y, Kivity S, Beinart R, Glikson M, Segev S, Goldenberg I, Maor E
Eur J Prev Cardiol 2016 Mar;23(5):511-7. Epub 2015 Jun 11 doi: 10.1177/2047487315591442. PMID: 26069245

Clinical prediction guides

Azevedo ACA, Barros MVL, Klaboe LG, Edvardsen T, Costa HS, Paixao GMM, Junior ORS, Nunes MCP, Rocha MOC
Int J Cardiovasc Imaging 2021 Sep;37(9):2727-2734. Epub 2021 Apr 21 doi: 10.1007/s10554-021-02246-8. PMID: 33881664
Teplitzky BA, McRoberts M, Ghanbari H
Heart Rhythm 2020 May;17(5 Pt B):881-888. doi: 10.1016/j.hrthm.2020.02.015. PMID: 32354454Free PMC Article
Kaushal M, Tolani P, Kumar N, Chopda A
Natl Med J India 2019 Jul-Aug;32(4):216-217. doi: 10.4103/0970-258X.291293. PMID: 32769242
Verba SD, Jensen BT, Lynn JS
Wilderness Environ Med 2016 Sep;27(3):364-70. Epub 2016 Jul 7 doi: 10.1016/j.wem.2016.03.005. PMID: 27396923
Sabbag A, Sidi Y, Kivity S, Beinart R, Glikson M, Segev S, Goldenberg I, Maor E
Eur J Prev Cardiol 2016 Mar;23(5):511-7. Epub 2015 Jun 11 doi: 10.1177/2047487315591442. PMID: 26069245

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